Feasibility & Initial Efficacy of a Culturally Sensitive Women-Centered Substance Use Intervention in Georgia: Sex Risk Outcomes

Background

This paper reports on the feasibility and initial efficacy of a culturally sensitive, comprehensive women-centered substance use intervention for women who inject drugs in Georgia in terms of the primary and secondary sex risk outcomes. The hypothesis under examination was that, relative to case management participants, participants in a culturally sensitive, comprehensive women-specific and -centered intervention would, on average, show significant decreases in past-30-day frequency of unprotected sex, unprotected sex at the last sexual encounter, and increases in condom use and safer sex actions.

Methods

The study was a two-arm randomized trial, in which 173 potentially eligible women were screened, and those 128 women determined to be eligible were assigned at random to either Reinforcement-based Treatment plus Women’s Co-Op (RBT + WC) or case management (CM). RBT + WC participants received 12 sessions of a structured intervention with the goal of reducing risky sex and substance use and improving physical and mental health. CM participants received 12 sessions of case management and informational brochures that focused on the same issues on which RBT + WC focused. Participants were assessed at baseline, post-treatment, and 3 months following treatment enrollment.

Results

Analyses revealed case management having significantly overall higher Safer Sex action scores than RBT + WC, and a significant decrease over time for past 30-day number of unprotected sex acts. Unprotected sex at the last encounter and Condom Use action scores were nonsignificant.

Conclusions

Women who inject drugs in Georgia are engaging in risky sexual practices, and are in need of an intervention that addresses these risky behaviors. Reasons for the failure to find differences between a culturally sensitive, comprehensive women-centered intervention and case management tailored to the needs of women who inject drugs in Georgia may have been the result of inadequate power to detect an effect in a sample whose drug use was not as serious as warranted by the intervention. 

Below:  Overall design of the IMEDI project

Below:  RBT Plus  WC intervention modules

Full article at: http://goo.gl/HbcbCA

By:   Hendrée E. Jones, Irma Kirtadze, David Otiashvili, Keryn Murphy, Kevin E. O’Grady, William Zule, Evgeny Krupitsky,and Wendee M. Wechsberg

UNC Horizons, Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, 127 Kingston Drive, Chapel Hill, NC 27514 USA

Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD 21224 USA

Addiction Research Center, Alternative Georgia, Tbilisi, 0177 Georgia

Ilia State University, Business School, Tbilisi, 0162 Georgia

Department of Psychology, University of Maryland, College Park, College Park, MD 20742 USA

Substance Abuse Treatment Evaluations and Interventions Research Program, RTI International, Research Triangle Park, ᅟ, NC 27709 USA

Department of Addictions, Bekhterev Research Psychoneurological Institute, St. Petersburg, 192019 Russia

Hendrée E. Jones, Phone: 1-919-966-9803, Email: ude.cnu.dem@senoJ_eerdneH.

 

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